Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)
- Volume 4 Issue 2
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- Pages.170-174
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- 2006
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- 1738-1320(pISSN)
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- 2508-6332(eISSN)
A Case of Acute Dapsone Poisoning Complicated with Methylene Blue-induced Hemolytic Anemia
급성 댑손 중독 환자에서 메틸렌블루 치료중 유발된 메트헤모글로빈혈증과 중증 용혈성 빈혈 1례
- Lee, Mi-Jin (Departments of Emergency Medicine, College of Medicine, The Catholic University of Korea) ;
- Park, Kyu-Nam (Departments of Emergency Medicine, College of Medicine, The Catholic University of Korea)
- Published : 2006.12.31
Abstract
Methylene blue is a basic thiazine dye frequently used for histologic staining. In clinical toxicology settings, it is also used to treat clinically significant methemoglobinemia. It has dose-dependent oxidation or reduction properties, acting as a reducing agent at lower doses and as an oxidizing agent at higher doses. Hemolytic anemia and hyperbilirubinemia are known toxic effects of methylene blue treatment that have been reported clinically. A 42-year-old woman developed significant methemoglobinemia after acute dapsone overdose; she was treated appropriately with intravenous methylene blue in the therapeutic range. The patient's methemoglobin levels returned to normal. However, 2-4 days later she was noted to have rebound methemoglobinemia, hemolytic anemia, and hyperbilirubinemia. A repeat of Coomb's test and other anemia workups were negative. For management of methylene blue-induced hemolytic anemia, she was administered steroid therapy, N-acetylcysteine, and a blood transfusion. She ultimately recovered, and there were no long-term sequelae from the methylene blue poisoning.